A surgical case for hemolytic anemia after ascending and total arch replacement.

A 61-year-old man presented with consistent hemolytic anemia 15 months after ascending and total arch replacement for DeBakey I type acute aortic dissection. The cause of hemolysis turned out to be mechanical damage of red blood cells at the inverted felt of the proximal anastomosis. Reoperation of resection of the felt and repair of the proximal anastomosis successfully resolved this problem. We report a rare case of hemolytic anemia at the site of inverted felt strip after total arch replacement.